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General NPI Number Information
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NPI Number | 1003845876
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Entity Type | Organization
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Legal Business Name | CALIFORNIA FOOTHILLS MEDICAL ASSOCIATES INC
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 11/05/2008
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Provider Practice Location Address
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Address Line | 8211 ROCHESTER AVE SUITE 101
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3903
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Country | US
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Telephone | 909-945-2425
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Fax | 909-948-6971
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Provider Business Mailing Address
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Address Line | 8211 ROCHESTER AVE SUITE 101
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3903
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Country | US
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Telephone | 909-945-2425
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Fax | 909-948-6971
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. ARNOLD IRA ROTH
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Credential | M.D.
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Telephone | 909-945-2425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G66000
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License Number State | CA
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